Future Care Costs After Catastrophic Injury: What Compensation Can Include

A catastrophic injury can change every aspect of a person’s life in an instant. Injuries such as traumatic brain injuries, spinal cord injuries, amputations, and severe orthopaedic injuries often require extensive and lifelong care. For many individuals and their families, the financial impact of these injuries can be overwhelming.

In Ontario, people who suffer catastrophic injuries may be entitled to compensation that includes the cost of their future care. Understanding what future care costs are and how they are addressed through accident benefits and tort claims is an important step toward securing the support needed for long-term recovery and quality of life.

Key Takeaways

• Future care costs are the ongoing expenses an injured person may reasonably incur because of a catastrophic injury and its long-term effects.
• Ontario accident benefits may provide funding for medical treatment, rehabilitation, and attendant care, but these benefits are often insufficient to cover lifetime care needs in catastrophic injury cases.
• A tort claim may allow an injured person to pursue additional compensation for future care costs when another party is at least partly responsible for the injury.
• Future care claims can include expenses related to rehabilitation, attendant care, assistive devices, home and vehicle modifications, case management, and housekeeping assistance.
• Expert evidence from medical professionals, rehabilitation specialists, and life care planners plays a critical role in assessing and valuing future care needs.
• Strict deadlines apply to accident benefits claims and tort claims in Ontario, making early legal guidance important after a catastrophic injury.

What Are Future Care Costs

Future care costs refer to the ongoing expenses that an injured person will reasonably incur as a result of their injuries and increased care needs. These costs are often significant in catastrophic injury cases, because the injured person may require care and support for the rest of their life (including costly items like 24/7 support and housing or vehicle modifications).

Future care costs are typically assessed with the help of medical professionals, rehabilitation experts, and life care planners. These experts evaluate the injured person’s condition and create a detailed plan outlining the care, services, and equipment they will need for the rest of their life.

The goal is to ensure that the injured person has access to the resources necessary to maximize their independence, safety, and overall well-being.

Accident Benefits Coverage for Future Care

In Ontario, accident benefits are available to individuals injured in motor vehicle accidents, regardless of who is at fault. These no-fault benefits are governed by the Statutory Accident Benefits Schedule.

For individuals who meet the legal definition of having sustained a catastrophic impairment, the level and length of available coverage is significantly higher than for non-catastrophic injuries.

Catastrophically injured individuals may be eligible for up to 1 million dollars in combined medical and rehabilitation benefits and attendant care benefits (unless they have purchased additional optional benefits, in which case, this amount may be higher).  This amount can be used for:

• Reasonable and necessary rehabilitative treatment, therapies, and support services; and
• Attendant care to assist with personal needs such as dressing, bathing, and mobility

These benefits are intended to help fund immediate and ongoing recovery needs. However, in many catastrophic injury cases, the available accident benefits coverage is not sufficient to cover the full cost of lifetime care – this is where a tort claim is critically important.

Tort Claims and Recovery of Future Care Costs

If another party is at least partly responsible for causing the injury, the injured person may pursue a tort claim (a lawsuit) to recover additional compensation beyond what is available through accident benefits, including future care costs.

Future care damages in a tort claim can include:

Medical and Rehabilitation Expenses

This includes the cost of ongoing therapies such as physiotherapy, occupational therapy, speech language therapy, and psychological counselling. It may also include specialized medical treatments and medications required over time.

Attendant Care and Personal Support

Many catastrophically injured individuals require assistance with daily living activities. Compensation can include the cost of professional caregivers or support workers who provide care in the home or in a specialized setting.

Assistive Devices and Equipment

Future care costs often include mobility aids such as wheelchairs, walkers, and prosthetics, as well as communication devices and other adaptive technologies. These items may need to be replaced periodically over the person’s lifetime.

Home and Vehicle Modifications

Injuries can make it difficult or impossible to navigate a standard home or vehicle. Compensation may cover the cost of modifying a home to include ramps, lifts, widened doorways, and accessible bathrooms. Vehicle modifications may also be required to allow for safe transportation.

Case Management Services

Catastrophic injury cases often involve complex care needs. A case manager may be required to coordinate medical care, rehabilitation services, and support providers. The cost of ongoing case management can form part of a future care claim.

Housekeeping and Home Maintenance

If an injured person is no longer able to perform household tasks, compensation may include the cost of hiring assistance for cleaning, maintenance, and other domestic responsibilities.

Future Income Loss and Loss of Competitive Advantage

Although technically separate from care costs, future income loss is often closely tied to catastrophic injuries. Compensation may be available if the injured person is unable to return to work or is limited in their ability to earn income in the future.

The Importance of Proper Assessment

Accurately assessing future care needs is essential. If these costs are underestimated, the injured person may not have sufficient funds to meet their needs later in life.

Courts in Ontario rely heavily on expert evidence when determining appropriate compensation for future care. Life care planners, physicians, and other specialists provide detailed reports that form the foundation of these claims.

An experienced personal injury lawyer will work with these experts to ensure that all aspects of the injured person’s future needs are identified and properly valued.

Family Member Claims

Family members of catastrophically injured individuals may also have legal rights. Under the Family Law Act, certain relatives may claim compensation for their own losses, including the loss of care, guidance, and companionship.

Family members may also be able to recover expenses they incur while supporting their loved one, including time spent providing care and out of pocket costs.

Certain family members can also open their own accident benefits claims for necessary services like counselling, following catastrophic injury or loss of a loved one. 

Timelines and Legal Considerations

Both accident benefits claims and tort claims are subject to strict deadlines in Ontario.

In most cases, injured individuals must:

• Notify their insurer within 7 days of the accident;
• Submit an application for accident benefits within 30 days of receiving the application package; and 
• Commence a tort claim within 2 years of the date of the accident under the current Rules of Civil Procedure

There are additional relevant timelines to advance claims against municipalities and/or related to injuries caused by snow and ice, such as slip and fall (occupiers’ liability) cases.

Failing to meet these deadlines can jeopardize the ability to advance claims and recover compensation.

Given the complexity of catastrophic injury claims and the importance of securing adequate future care funding, it is important to seek legal advice as soon as possible.

How Oatley Vigmond Can Help

Catastrophic injury cases require a thorough understanding of both the medical and legal issues involved. The personal injury lawyers at Oatley Vigmond have extensive experience representing individuals with serious and life-altering injuries.

Our team works closely with leading medical experts, rehabilitation professionals, and life care planners to build strong claims that reflect the true needs and costs of future care. We are committed to helping our clients access the compensation they need to support their recovery and maintain dignity and independence.

If you or a loved one has suffered a catastrophic injury, speaking with an experienced lawyer can make a meaningful difference in your case.

Frequently Asked Questions

What are future care costs in a catastrophic injury claim?

Future care costs are the ongoing expenses an injured person is expected to incur because of a serious and life altering injury. According to the blog, these costs can include medical treatment, rehabilitation services, attendant care, assistive devices, home modifications, transportation adaptations, and other supports required over time. In catastrophic injury cases, future care costs are often significant because the individual may require assistance and specialized services for many years or even for life. The purpose of a future care assessment is to identify the resources necessary to maximize the injured person’s safety, independence, and quality of life.

How are future care needs assessed after a catastrophic injury?

The blog explains that future care needs are typically assessed by a team of professionals that may include physicians, rehabilitation experts, and life care planners. These experts evaluate the individual’s injuries, functional limitations, and long-term support requirements. They then prepare reports outlining the care, equipment, services, and assistance that may be required in the future. Courts and insurers often rely heavily on these assessments when evaluating compensation claims. A thorough assessment helps ensure that future needs are identified accurately and that important care requirements are not overlooked.

Are future care costs covered by Ontario accident benefits?

Yes. Ontario’s accident benefits system may provide funding for future care needs following a motor vehicle accident, regardless of who caused the collision. The blog notes that catastrophically injured individuals may have access to significantly higher levels of medical, rehabilitation, and attendant care funding than those with non-catastrophic injuries. These benefits can help pay for treatment, rehabilitation, and personal support services. However, because catastrophic injuries often create lifelong needs, accident benefits alone may not be sufficient to cover all future expenses. This is one reason why many serious injury cases also involve a tort claim.

What future care expenses can be included in a tort claim?

According to the blog, future care damages may include a wide range of expenses related to an injured person’s long-term needs. These can include rehabilitation services, attendant care, assistive devices, wheelchairs, prosthetics, communication technologies, home modifications, vehicle adaptations, case management services, housekeeping assistance, and home maintenance support. The purpose of these damages is to help ensure that the injured person has access to the care and resources required because of their injuries. The specific expenses included will depend on the individual’s circumstances and the evidence supporting the claim.

Why are home and vehicle modifications often included in future care claims?

Catastrophic injuries can make it difficult or impossible for an individual to safely use a standard home or vehicle. The blog explains that compensation may be available for modifications such as ramps, lifts, widened doorways, accessible bathrooms, and vehicle adaptations. These changes can help improve mobility, independence, and safety. For example, a family in Vaughan caring for a loved one with a spinal cord injury may need significant home modifications to accommodate wheelchair access. Future care assessments often evaluate these needs as part of a comprehensive long-term care plan.

What is attendant care and how does it relate to future care costs?

Attendant care refers to assistance with personal and daily living activities that an injured person may no longer be able to perform independently. According to the blog, this can include support with dressing, bathing, mobility, and other personal care needs. In catastrophic injury cases, attendant care may be required on an ongoing basis and can represent a substantial component of future care costs. Compensation may include funding for professional caregivers or support workers who provide assistance either at home or in another care setting, depending on the individual’s needs.

Why is expert evidence important in future care claims?

The blog emphasizes that Ontario courts rely heavily on expert evidence when assessing future care costs. Medical specialists, rehabilitation professionals, and life care planners help identify the services and supports that will likely be required in the future. Their reports provide the foundation for estimating long-term expenses and demonstrating why those costs are necessary. For individuals in Toronto dealing with a catastrophic injury, expert evidence can help explain how the injury affects daily life and what resources may be required to maintain independence and quality of life over time.

Can family members claim compensation related to future care needs?

Yes. The blog explains that certain family members may have legal rights under Ontario’s Family Law Act. In some situations, family members may claim compensation for losses arising from the injury, including loss of care, guidance, and companionship. Family members may also be able to recover certain expenses they incur while helping care for an injured loved one. In addition, some relatives may be eligible to access accident benefits for services such as counselling following a catastrophic injury or loss. The available rights and benefits depend on the circumstances of each case.

What deadlines apply to future care claims in Ontario?

The blog notes that both accident benefits claims and tort claims are subject to important deadlines. In many cases, injured individuals must notify their insurer within seven days of the accident, submit an accident benefits application within thirty days of receiving the application package, and commence a tort claim within two years of the accident. Additional timelines may apply in cases involving municipalities or snow and ice related incidents. Because missing a deadline can affect a person’s ability to pursue compensation, obtaining legal advice early is often recommended.

When should I speak with a lawyer about future care costs?

The blog recommends seeking legal guidance as soon as possible after a catastrophic injury. Early involvement allows a lawyer to help coordinate expert assessments, preserve evidence, identify future care needs, and ensure that applicable deadlines are met. For families in Barrie facing the challenges of a severe brain injury, spinal cord injury, or amputation, understanding future care requirements often becomes an important part of planning for the future. Obtaining advice early can help ensure that the full scope of long-term needs is properly considered throughout the claims process.

Contact Us for a Free Consultation

Understanding your rights after a catastrophic injury is essential to protecting your future. The personal injury lawyers at Oatley Vigmond are here to guide you through the process, help you access accident benefits, and pursue full compensation through a tort claim.

Please contact us today to arrange a free consultation and learn more about how we can assist you or your loved one with securing compensation for future care costs.